A medical nurse is caring for a patient with type 1 diabetes. The patient's medication administration record includes the administration of regular insulin three times daily. Knowing that the patient's dinner tray will arrive at 1645, when should the nurse administer the patient's insulin to ensure the onset of the insulin coincides with the start of the meal?

1645

1615

1545

1600

Answer and Explanation

The Correct Answer is B

A. Regular insulin typically begins to take effect 30 minutes after administration. Administering insulin at the time of the meal (1645) would not allow enough time for the insulin to reach its onset of action, potentially resulting in the blood glucose level being high during the meal.

B. Regular insulin has an onset of action of 30 minutes. By administering the insulin at 1615, it will start to take effect by 1645, when the meal arrives, and help ensure the insulin action aligns with the meal, preventing postprandial hyperglycemia.

C. Administering insulin at 1545 would be too early and could lead to the insulin peaking before the meal, which could result in hypoglycemia if the insulin peak occurs before the patient has food to absorb the glucose.

D. Administering insulin at 1600 would result in the insulin starting to work too soon, with the onset happening before the meal and possibly leading to hypoglycemia if the insulin peaks before the meal is consumed.

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Correct Answer is B

Explanation

A. Leukemia:
Explanation: Leukemia is a cancer of the blood-forming tissues, including the bone marrow and lymphatic system. It typically presents with an abnormal increase in white blood cells. While fatigue can be a symptom, increased bilirubin concentration and an increased reticulocyte count are not typical findings in leukemia.

B. Hemolytic Anemia:
Explanation: Hemolytic anemia is characterized by the premature destruction of red blood cells, leading to an increased release of bilirubin (from the breakdown of hemoglobin) and an increased reticulocyte count (as the body attempts to compensate by producing more red blood cells). This is a likely possibility given the presented symptoms.

C. Hypoproliferative Anemia:
Explanation: Hypoproliferative anemia is characterized by a decreased production of red blood cells. It is unlikely in this scenario, as an increased reticulocyte count suggests an attempt by the bone marrow to increase red blood cell production.

D. Thrombocytopenia:
Explanation: Thrombocytopenia is a condition characterized by a low platelet count. It does not typically present with an increased bilirubin concentration or an increased reticulocyte count.

A. Urinalysis shows trace protein B. Hemoglobin A1C of 5.6% C. Fasting blood glucose of 110 mg/dL D. Urine ketones are negative

Correct Answer is B

Explanation

A. Urinalysis shows trace protein:
Explanation: While trace protein in the urine is generally better than higher levels, it doesn't provide a specific measure of blood glucose control. Protein in the urine can be an early sign of kidney damage in diabetes, but it doesn't directly indicate blood glucose control.

B. Hemoglobin A1C of 5.6%:
Explanation: Hemoglobin A1C (HbA1C) is a long-term indicator of blood glucose control. An HbA1C level of 5.6% is within the target range for individuals with diabetes and suggests good control of blood glucose over the past 2-3 months.

C. Fasting blood glucose of 110 mg/dL:
Explanation: Fasting blood glucose gives a snapshot of blood glucose at a specific moment. While 110 mg/dL is a fairly normal fasting level, it doesn't provide information about long-term control. A single fasting glucose measurement may not reflect overall glucose management.

D. Urine ketones are negative:
Explanation: Negative urine ketones indicate that the body is not currently using fat for energy. While this is a good sign in the moment, it doesn't give information about overall blood glucose control over time. Urine ketones can fluctuate based on various factors, including diet and activity level.

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Naxlex Comprehensive Predictor Exams

A client comes into the clinic complaining of fatigue. Blood work shows an increased bilirubin concentration and an increased reticulocyte count. What would the nurse suspect the patient has?

Correct Answer is B

Explanation

A patient is seeing the nurse practitioner for a 6 months checkup for diabetes mellitus. While reviewing the patient's lab results, which lab best represents the patient has good control of the disease?

Correct Answer is B

Explanation

The nurse is collecting data for a client who has been diagnosed with iron-deficiency anemia. What subjective findings does the nurse recognize as symptoms related to this type of anemia?

A client with diabetes mellitus is ordered to receive insulin for glucose correction (sliding scale coverage). The nurse knows the rapid acting insulin Insulin Lispro (Humalog) onset and peak action time are:

The nurse is monitoring a client who was diagnosed with Type 1 Diabetes Mellitus and is being treated with NPH and regular insulin. Which manifestations alert the nurse to the presence of a possible hypoglycemic reaction? (SELECT ALL THAT APPLY)

The nurse instructs the client about the self-administration of insulin. Which statement or statements by the patient indicate a need for further teaching? (SELECT ALL THAT APPLY)

A client diagnosed with type 1 diabetes states he is not comfortable with self-injections and asks the nurse if oral an anti- diabetic agent can be prescribed instead. Which of the following responses from the nurse is appropriate?

The nurse is discussing macrovascular complications of diabetes with a client. The nurse would address what topic during this dialogue?

A client with chronic kidney disease has chronic anemia. What pharmacologic alternative to blood transfusion may be used for this patient?